Addressing co-occurring chronic pain and obesity simultaneously in a behavioral intervention: a pilot trial

Area of Science:

• Obesity and Pain Management
• Behavioral Medicine
• Digital Health Interventions

Background:

• Chronic musculoskeletal pain and overweight/obesity frequently coexist, creating a complex health challenge.
• Existing interventions for this comorbidity are limited, particularly those addressing underlying reward processes.
• This study focuses on an integrated approach to manage both conditions simultaneously.

Purpose of the Study:

• To evaluate the feasibility and acceptability of a remotely delivered integrated intervention for comorbid overweight/obesity and chronic musculoskeletal pain.
• To assess the intervention's impact on weight, pain, and related functional outcomes.
• To explore the role of environmental reward processes and positive affect in managing this comorbidity.

Main Methods:

• A single-arm trial involving participants aged 45-80 with overweight/obesity (BMI ≥ 25 kg/m²) and moderate-to-high impact musculoskeletal pain.
• A remotely delivered intervention combining behavioral weight loss and cognitive-behavioral pain coping strategies.
• Assessments of weight, pain (PROMIS scales, SPPB), and process variables at baseline, 4 months, and 8 months.

Main Results:

• High participant engagement and satisfaction were reported, with 76% completing the core intervention.
• Significant reductions in pain impact (4.0 points) and modest weight loss (2.4% of baseline) were observed at 4 months.
• Further improvements in pain and weight were noted for participants completing the elective phase.

Conclusions:

• A remotely delivered integrated weight loss and pain reduction intervention is feasible and acceptable for individuals with comorbid conditions.
• The intervention demonstrated positive effects on both pain and weight management.
• Results support further investigation in a larger, powered clinical trial.